Provider Demographics
NPI:1528824729
Name:KILLORAN, DEVON (CCC-SLP)
Entity type:Individual
Prefix:
First Name:DEVON
Middle Name:
Last Name:KILLORAN
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3022 W ADDISON ST APT 2E
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60618-4537
Mailing Address - Country:US
Mailing Address - Phone:678-296-7519
Mailing Address - Fax:
Practice Address - Street 1:3022 W ADDISON ST APT 2E
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60618-4537
Practice Address - Country:US
Practice Address - Phone:678-296-7519
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-02-26
Last Update Date:2024-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL146.017433235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty